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									                            Waterloo Chamber of Commerce

                             Annual Scholarship Application


Applicant’s name _______________________________ Soc. Sec. # ___________________________

Address _______________________________________ Phone # ____________________________

High School Attending _______________________________________________________________

Class Rank ____________ GPA _____________ SAT Score ____________ ACT Score ____________

List below school and community activities you are involved in and awards or recognition received.
(Attach additional sheets as needed.)



List of Job Experiences (Attach additional sheets as needed).




Please provide written references from at least two people (not relatives). At least one of the
references should be a staff member of your school. Please list their names and phone numbers below.

Name __________________________________________________ Ph. # ____________________

Name __________________________________________________ Ph # ____________________



Please attach a copy of your current transcript.



Return completed application on or before April 15th to: Waterloo Chamber of Commerce, 118 E.
Third Street, P.O. Box 1, Waterloo, IL 62298.
The Waterloo Chamber of Commerce is interested in supporting and advancing educational
opportunities for youth in the Waterloo community. To help our dynamic local students meet
the ever-rising costs of seeking higher education, the Chamber will offer two $1,000.00
scholarships to graduating seniors: one from Waterloo High School and one from Gibault
Catholic High School. The Chamber of Commerce is now accepting applications for this annual
scholarship.



To be considered, the applicant must meet the following criteria:



      A resident of Waterloo for at least 12 months prior to application.
      A senior this year and planning to enter an accredited college, university, junior college
       or vocational school in the fall of this year.
      Submit a completed application including a written response to an essay question.
      Provide two letters of recommendation with at least one from a staff member of the
       high school.
      Submit a current transcript indicating performance, honors and class rank.
      Demonstrate interest in community service.
      Demonstrate character and personality – maturity, motivation, moral character and
       leadership skills.



Applications are available at each school’s guidance office, the Waterloo Chamber of
Commerce located at 118 E. Third Street or onlinr (under forms) at www.enjoywaterloo.com
.The completed applications must be returned to the above-mentioned address on or before
April 15th. Applications received after the deadline will not be considered. The winner of the
scholarship will be announced at the May membership meeting and will be personally
contacted by the Chamber of Commerce Executive Director, Debbie Ruggeri.
WATERLOO CHAMBER OF COMMERCE SCHOLARSHIP APPLICATION



General Information



Please print or type



Name:_____________________________________________________________________________

Street Address: _____________________________________________________________________

City, State, Zip code __________________________________________________________________

Telephone: ____________________ Email: ______________________________________________

Date of Birth: ______/______/______

Name of high school:_________________________________________________________________

College, University, Community College, or Vocational School you plan to attend:

___________________________________________________________________________________

Colleges, University, Community Colleges, or Vocational Schools you are applying to for admission:

___________________________________________________________________________________

Grade Point Average _______________________ Date of Application: ________/________/________




                          Please attach high school transcript to application
Work Experience:




Honors and Awards:
List below, or attach sheet if needed, all honors and awards received during high
school.




School Participation:
List below, or attach sheet if needed, all sports, clubs, and organizations in which you
have actively participated during high school. Includes offices held and years of
membership.




Community Service:
List below, or attach sheet if needed, any community service work or groups in which
you have actively participated in during high school.
Written Statements:

   1. What is your goal for yourself in the future?




   2. What steps have you taken so far to help you reach those goals? (For example,
      academics, activities both in school and out of school, volunteer work, etc.)




Essay:

On a separate sheet, please respond to one of the questions listed below. (300-500
words)

   1. The community of Waterloo is growing and changing. What does the future of
      Waterloo look like to you? What changes would you like to see for Waterloo and
      what would you like to see preserved.
   2. Why should the Chamber of Commerce select you for this scholarship?




I certify that the above statements are true, and if awarded a Waterloo Chamber of
Commerce Scholarship, I will enroll in a college, university, community college or
vocational school in the fall of the year.


_____________________________________________________________________
Signature of Applicant                           Date

This application, including transcript, must be received in the Chamber Office by
April 15th. Late or incomplete packages will be disqualified. No exceptions.
Good Luck!
                       WATERLOO CHAMBER OF COMMERCE
                  Letter of Recommendation Form for Staff Member



This Part to be completed by the Applicant

Applicant’s Name: ___________________________________________________________

Street Address: _____________________________________________________________

City, State, Zip code _________________________________________________________

Telephone:_____________________ Email: ______________________________________

Name of high school:_________________________________________________________

Name of Person providing Letter of Recommendation: ______________________________

Staff member’s Position at your High School: _____________________________________



Applicant's Statement: I understand this letter of evaluation is to be received and maintained
in confidence by the Waterloo Chamber of Commerce for consideration of a $1000.00 student
scholarship. I hereby expressly waive any and all rights I might have of access to this
evaluation.

      I agree to waive access to this statement from the recommender.
      I do not agree to waive access to this statement from the recommender.


Signature of Applicant ____________________________________ Date _______________

Applicant, please mail or give this form to your recommender.

RECOMMENDER - Please mail to:

Waterloo Chamber of Commerce Scholarship Fund, P.O. Box 1, 118 East Third Street,
Waterloo, Illinois 62298



Or return to applicant in a sealed envelope.
This part to be completed by the recommender:



To the Recommender:

We would appreciate your opinion of ________________________________, an applicant for
the Waterloo Chamber of Commerce $1000.00 Scholarship award. The Chamber is particularly
interested in an evaluation of the applicant’s potential for academic and community service
achievement, and evidence of the student’s present and potential positive influence on
others/the world.

Explicit descriptions of academic and personal strengths and weaknesses are more helpful to
the candidate than routine praise. Comments about character, integrity or motivation are also
appreciated, if pertinent. The experience upon which your opinion is based should be described.
Rankings should be related to other students in the same class or academic program or other
persons of comparable experience.

You may use this recommendation form, or create your own personal letter of recommendation.
(If you write a separate letter, please attach your letter of recommendation to this completed
document.)

1. How well have you known this student, and in what context?




2. What are the first words that come to your mind to describe this student?




3. In your opinion, what are the student’s greatest strengths that would enable the student to
   represent the mission of the Chamber of Commerce and positively influence others/the
   world?


Staff person’s name _____________________________________ Title: ________________

High School: ________________________________________________________________

Work phone: ________________________ Work email: ______________________________



Signature: ____________________________________________ Date: _________________



                       Waterloo Chamber of Commerce Mission Statement
   To help promote a prosperous business climate and quality of life for the businesses and people of
                                             Waterloo.
                           WATERLOO CHAMBER OF COMMERCE
                            Letter of Recommendation Form #2



This Part to be completed by the Applicant

Applicant’s Name: ___________________________________________________________

Street Address: _____________________________________________________________

City State, Zip code _________________________________________________________

Telephone:_____________________ Email: ______________________________________

Name of high school:_________________________________________________________

Name of Person providing Letter of Recommendation: ______________________________

Recommender’s relationship to the applicant: _____________________________________

Applicant's Statement: I understand this letter of evaluation is to be received and maintained
in confidence by the Waterloo Chamber of Commerce for consideration of a $1000.00 student
scholarship. I hereby expressly waive any and all rights I might have of access to this
evaluation.

      I agree to waive access to this statement from the recommender.
      I do not agree to waive access to this statement from the recommender.


Signature of Applicant __________________________ Date _________________________

Applicant, please mail or give this form to your recommender.

RECOMMENDER - Please mail to:

Waterloo Chamber of Commerce Scholarship Fund

P.O. Box 1

118 East Third Street

Waterloo, Illinois 62298



Or return to applicant in a sealed envelope.
This part to be completed by the recommender:

To the Recommender:

We would appreciate your opinion of ________________________________, an applicant for
the Waterloo Chamber of Commerce $1000 Scholarship award. The Chamber is particularly
interested in an evaluation of the applicant’s potential for academic and community service
achievement, and evidence of the student’s present and potential positive influence on
others/the world.

Explicit descriptions of academic and personal strengths and weaknesses are more helpful to
the candidate than routine praise. Comments about character, integrity or motivation are also
appreciated, if pertinent. The experience upon which your opinion is based should be described.
Rankings should be related to other students in the same class or academic program or other
persons of comparable experience.

You may use this recommendation form, or create your own personal letter of recommendation.
(If you write a separate letter, please attach your letter of recommendation to this completed
document.)

4. How well have you known this student, and in what context?




5. What are the first words that come to your mind to describe this student?




6. In your opinion, what are the student’s greatest strengths that would enable the student to
   represent the mission of the Chamber of Commerce and positively influence others/the
   world?




Recommender’s name ___________________________________ Title: ________________

Profession: __________________________________________________________________

Work phone: ________________________ Work email: ______________________________



Signature: ____________________________________________ Date: _________________



                       Waterloo Chamber of Commerce Mission Statement
   To help promote a prosperous business climate and quality of life for the businesses and people of
                                             Waterloo.

								
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